Hepatocellular carcinoma (HCC) is one of the most common malignancy tumors in human and its incidence is still increasing. This malignancy continues to be a significant cause of cancer morbidity and mortality worldwide. The cause, development, evolution, diagnosis and treatment of hepatoma are of great interest. The early detection of HCC is critical for successful treatment and prognosis.
Currently, AFP is the principal marker for Hepatocellular carcinoma (HCC), which has been used as a serum marker of HCC for many years, and it has been recently used in the genetic diagnosis for HCC hematogenous spreading metastasis. However, said method still has problems in its specificity and its sensitivity. For specificity, the interfering factor for the accuracy of the diagnosis is mainly caused by AFP proteins and the mRNA thereof detected in some patients with cirrhosis or chronic hepatitis. Authoritative statistic suggests that positive rates of serum AFP are 19.8% in patients with acute bilious hepatitis, 19.9% in patients with chronic migratory hepatitis, and 34.4% in chronic active hepatitis, respectively, and up to 44.6% in patients with cirrhosis after hepatitis. The serum AFP concentration of the above non-HCC liver diseases usually is 25-200 ng/ml. Comparing the results of Northern hybridization and immunohistochemical detection of the HCC and noncancerous liver tissue, weak positive AFP expression is usually found in noncancerous liver tissue. Therefore, false positive result of serum AFP protein usually incurs. When part of the liver cells detach into blood because of inflammatory or necrosis, AFP mRNA false positive result will appear in the blood. The research work done by one group of Matsmnura et al. shows that AFP mRNA positive is detected in 15% cirrhosis and 12% chronic hepatitis patients. In other group, Jiang et al. identified 6 AFP mRNA positive out of 11 patients, 1 AFP mRNA positive out of 2 acute hepatitis patients. For sensitivity, the serum AFP is negative in about ⅓ HCC patients (<20 ng/ml). The frequency of positive serum AFP in HCC of well differentiation (I level) and very bad differentiation (IV level) is also quite low, making the detection less efficient for these patients. This indicates the significant rate of missed diagnosis and erroneous diagnosis. Therefore, new markers with higher sensitivity and specificity are needed for improving the early diagnosis of HCC.
Because of the current need of effective method for HCC diagnosis and/or therapy with good specificity, it is urgent to develop specific mAb for HCC, as well as efficient methods for HCC diagnosis and therapy.